Ob-Gyn Coding Alert

Reader Question:

Medicare ABN

Question: Where can I find a concise version of a Medicare ABN form? Should we always add the -GA modifier to the service?

California Subscriber

Answer: Medicare has produced a one-page advance beneficiary notice (ABN) form, which can be downloaded from www.hcfa.gov/forms/ (scroll down the list until you come to the ABN forms). If you have the patient sign the ABN, you need to add modifier -GA (Waiver of liability statement on file) to the service if you suspect that it may be denied by Medicare. It is not necessary to get the patient to sign an ABN or to use the -GA modifier for any service that is never covered by Medicare (such as the annual well-woman preventive exam billed using the 993xx codes). An ABN needs to be signed and dated for each procedure or service you are performing that you suspect may not be covered by Medicare.

Answers for You Be the Coder and Reader Questions were provided by Melanie Witt, RN, CPC, MA, an independent coding educator and ob/gyn coding expert.